Active NPI
Alicia Marie Lacy, ATC
- Athletic Trainer
- Old Town, ME
National Provider Identifier
1659752269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT856
- Practice address
- 19 Bachelder Rd
Old Town, ME 04468-1217 - Phone
- (203) 843-2930
- NPI assigned
- Jun 10, 2015
- Last updated
- Aug 24, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT856 | ME | Primary |
Addresses
Primary practice location
19 Bachelder Rd
Old Town, ME 04468-1217
Mailing address
19 Bachelder Rd
Old Town, ME 04468-1217
Phone (203) 843-2930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT856 | ME | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1659752269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 BACHELDER RD",
"city": "OLD TOWN",
"state": "ME",
"postal_code": "044681217",
"telephone_number": "203-843-2930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 BACHELDER RD",
"city": "OLD TOWN",
"state": "ME",
"postal_code": "044681217",
"telephone_number": "203-843-2930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACY",
"first_name": "ALICIA",
"middle_name": "MARIE",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-10",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ME",
"license": "AT856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Town, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.